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Keratoconus Caused by Eye-Rubbing?

Short version? NO. There is a significant genetic component.

Longer version: I recently read that KC is probably way more prevalent than we once thought. The newest studies show it's probably more like 1-in-400 patients instead of the previously-stated 1-in-12,000 or so. I was happy to hear this because prior to that I was seeing a LOT more KC patients than 1-in-12000. I just assumed it was our patient population (heavily Hispanic), but no, it was longstanding bad data. Then over the weekend I read this article by an MD who hypothesizes that KC is caused by eye-rubbing, which I personally very much disagree with. Eye rubbing is known to exacerbate KC and progress the corneal thinning and steepening of existing KC patients, but there is a LOT of data that shows it is genetic/inherited. The article isn't a study and doesn't present any real data to support the hypothesis. It's more of a "what if this were true - wouldn't that be a game changer!?" type of article. I know this is just anecdotal but MANY of my KC patients claim to never rub their eyes, before or after diagnosis. So then how did they get it? I don't have to present a lot of data in this blog post, it's already been presented for me over many, many years of journal articles and studies. It is widely accepted that KC is an inherited corneal ectasia. The author admits that his hypothesis is out of line with traditional thinking, and that it's not possible to prove his theory. The crux of his argument is that KC is poorly understood (that's true) so basically his theory is "possible". Kind of a Devil's advocate kind of presentation. Well OK there is a place for that in medicine, but I disagree that KC is "caused" by eye-rubbing. The vast majority of professionals agree that KC is a genetic/inherited corneal ectasia.